So I did a test. I stopped medication two days before it because I'm taking more than go prescribed and I wanted to know levels before I go to go for test.
So I was on 125 mg Dr has only prescribed 50
Tsh 0.01 0.27-4.2
T420.5 12-22
T3 5.72 3.1-6.8
Prolactin is very high was never before
102-496 667
Fsh and lh slightly high too.
Wondering if prolactin is because of perimenopause. I don't think I've any of the symptoms of it.
Just wondering if thyroid has any impact on it. Or if anyone knows what impacts it
Going to retest it in 4 weeks
All vitamins are good. High ferritin, b12 vit d and folate no issues
Medichexks said I'm hyper on results. So I'm gonna stop medication 4 days before gp tests me to avoid them saying the same.
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Jump1
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I'm taking iron and vitamin d k and mag. I take folate not as regular and b12 occasionally but those results are all high. Vit d is 135. Right good to know better reduce the levo then or the gp.will take away my 50 mg. Didn't know it took weeks to change. I've been medicating more on symptoms than results and how I feel. Yes I'm hashimotos. But the antibodies were only 1 over the range. They've been higher before and the prolactin was normal
Yes fill iron done as well but the rest was incomplete few then didn't get results for they want me to retest again for it. But those that did come through all look fine.
stopping for 4 days won't stop the GP saying the same thing . Medichecks comment says 'overmedicated' because the TSH is below range (T4/T3 are in range )
GP likely to say the same based on TSH level , no matter what fT4 levels are.
4 days with no levo is unlikely to get your TSH to rise much, if at all.
leaving a longer than recommended gap between last dose and blood test will affect fT4 result significantly, but not really the TSH.
TSH might rise a little bit in 4 days of no levo , or it might not move at all . both are equally likely .. but if it's been very low (and Ft4/3 have been very high) for quite a while, then it is likely to take weeks to move, not just a few days .
If your fT4 is this level after 48hrs then presumably it will be over range when you test properly (24 hrs ) .
Are you sometimes testing 'properly' for your own information ? ... hope so.
Yes I'm testing for myself. And I'm dosing on symptoms since november. Looks like I'm going to have to go back down to 50 mg before gp tests me. I can put off the test until end of may. My constipation was just starting to improve no pebblea and I'm starting to sweat agin just noticed today.
Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.
Traditionally we have tended to start patients on a low dose of levothyroxine and titrate it up over a period of months. RCT evidence suggests that for the majority of patients this is not necessary and may waste resources.
For patients aged >60y or with ischaemic heart disease, start levothyroxine at 25–50μg daily and titrate up every 3 to 6 weeks as tolerated.
For ALL other patients start at full replacement dose. For most this will equate to 1.6 μg/kg/day (approximately 100μg for a 60kg woman and 125μg for a 75kg man).
If you are starting treatment for subclinical hypothyroidism, this article advises starting at a dose close to the full treatment dose on the basis that it is difficult to assess symptom response unless a therapeutic dose has been trialled.
Constipation is common hypothyroid symptom. Magnesium citrate supplements supplements can help. Best taken afternoon or evening and minimum 4 hours away from levothyroxine
Calm vitality magnesium powder is cheap and easy to use. Best start on low dose and increase until get desired effect…..too much can cause diarrhoea
I take magnesium. I've had a mix of tablets. The chemist mixes them up no matter how many times I ring and then the private ones I source are diff too. I think once I'm on a brand for a while i've no reaction to it. Teva never impacted me in a bad way
We stop T4 meds 24 hours previous to having a test to get a more even average of circulating blood levels. Anytime after that levels begin decreasing so withholding meds for two days before the test isn’t really useful.
Your results are still quite high in range so indicate they could well have been over-range should you have tested using the correct protocol. Also it is unlikely TSH will rise that quickly for your GP’s observation as generally has quite a long time lag and/or may never raise at all.
Prolactin may be higher in ovulatory phase compared to follicular and luteal phases but isn’t usually recognised to raise significantly during menopausal changes. That would be FSH & LH hormones. In healthy women prolactin usually follows TSH so why it becomes elevated in undiagnosed hypothyroidism. I don’t know why your prolactin has become elevated because your thyroid hormone levels are more than adequate, unless you are suffering some sort of cell resistance.
Taking thyroid hormones too high won’t necessarily bring better well-being and can actually backfire by making you feel worse. If raising your meds hasn’t reduced your symptoms or ended up making you further symptomatic you will need to reduce your dose.
I've been feeling better not worse. I'll reduce the dose bow to see what happens. That's in the follicular stage that the prolactin is so high. It's never been out of range before.what do you mean by cell resistance
All thyroid meds require certain conditions to be met in order to work effectively. These conditions generally refer to what we think of as being healthy, ie optimal iron & nutrients, balanced sex hormones, adequate cortisol levels, low bodily inflammation, etc, etc.
If a condition isn't right it can impair how thyroid hormones can work quite substantially. For instance not having enough cortisol with impair glucose metabolism which in turn can prevent good thyroid hormone uptake, ie we have enough thyroid hormone but it can't get into the cells to become active because of blood sugar imbalances .
High inflammation can also act very negatively on the enzymes that act to help the thyroid hormone into the cell. These are only two examples. There are many more and also genetic cell resistance but I wasn't referring to that.
As far as I know there's never been a problem with my heart rate and blood pressure. Not been something I've every noticed or had to go to dr about. I do have to say my symptoms do feel like they have reduced on this level. Like fluid retention in my body and face eyelids aren't dropping. Hands and legs not as swollen feel warmer starting to sweat at long last constipation improving at long last. So it's odd that bloods according to everyone and the range mean I'm bad. Because I feel better than I have done I. A long long time. But in order to not loose the 50mg I do need the TSH to go back up. Or it will make it harder for me and more expensive to maintain my increased soaage. I was judging how I was feeling on the dosage
Hi Jump 1, high Prolactin can also be connected with secondary thyroidism, which is when the problem is not with the thyroid so much as the pituitary gland. It can result in very low TSH even when the thyroid hormone levels are still low in range. I’ve been sent recently for an mri to check out the pituitary gland for this reason and one of the tests was prolactin levels……. I’m no expert though…..
Thanks I read that gland was the cause of it. I did wonder about ,7 or 8 years ago I got.hit on head with half a block at that point needed staples. Didn't knock me out Wonder if that caused some damage to it I'll have to test it again in 4 weeks time. Just odd that it is through the roof and it wasn't over any range before.
I once became overmedicated on Levothyroxine. I didn't really have any symptoms but my FT4 was up near 30, where the top of the range was 22 or so. My TSH was suppressed, and it has taken about 3 years of being systematically undermedicated by the GP for the TSH to rise to about 2 where I can now justify asking for a dose increase. The problem is that unless you are undermedicated your TSH won't rise. Just taking the correct dose (for you, whatever that is) won't change your TSH once it drops. Sorry that's not good news for you. You will probably have to rely on pointing out to the GP that because your FT4 is in range you are not overmedicated, even if your TSH is below range. If he also tests FT3 you could point out that it isn't over-range either, but I guess he probably wont. You would also need to come clean about your current dose being 125mg. Maybe you could blame the pandemic and the decreased access to health care.
Did you ever go and ask for an increase from 50mcg last year ? or did you just assume they wouldn't give it you ...
increasing it by yourself while they still think you only take 50mcg has created a problem for yourself , which leaves you in quite a tricky situation now .
..... It would have been easier to push the GP for an increase from when you were actually taking 50 than it will be to deal with where you are now .
There are arguments / references you could have used to get an increase to 75mcg (and then further increases if needed ) when your TSH was 2 something on 50mcg.
.... But now, even if you reduce dose and get TSH to come back into range , the GP will think your TSH is 'very low' on 50mcg , so they are likely to panic and worry that they are overmedicating you by giving you any Levo at all .
It would probably take a long while (months ) at a significantly lower dose than you have been on to get your TSH to rise back anywhere near 2 ish. ( and doing this will obviously make you feel unwell again)
and anyway .. you can't keep doing that to yourself every year just to keep a 50mcg prescription... making changes to that degree over several years will do your body and your HPT axis no good .. not to mention the lost months each year when you feel crap again.
But the the biggest concern is that once we find a dose where we feel better .. if we meddle with our dose and then put it back , we often don't go back to feeling as good again once we put the dose back up ..... thyroid hormone levels really don't like being fiddled with .. they like stability , and gradual changes, not sudden lurches between enough /too little/ enough.
Honestly i think your best bet is to reduce to 100mcg, test , then 'come clean' with GP so they understand your lower TSH is because of taking a higher dose , rather than have them assume it is because 50mcg is overmedicating you .
Take 100mcg for 6 weeks as slow dragon suggested .
Stall the GP blood test for long enough to let a GP see a proper test on 100mcg ('holiday abroad' ?). *Note ... Tell the phlebotomist at the time of the blood draw that you were actually on 100mcg , so the GP will be aware as soon as she sees results . (Keep everything open and 'above board', for now .. otherwise they will get nervous)
Book appt. with GP to discus results .
Explain that you tried an increase by yourself ... (say you didn't want to bother them during the pandemic , say you tried 125mcg and that was when you really felt better but you didn't think you should take 125mcg without checking bloods on 100mcg first so you have gone back to 100mcg for 6 weeks ) .. and most importantly , let them know you felt so much better, describe which symptoms improved and relate the improvements to ' function /work / family relationships' rather than anything 'cosmetic ' .
You may have to accept a few more months of a slightly lower dose than you want ..eg. it may be a bit of a struggle to get them to agree to increase from 100 to 125mcg ... but i think this is a much safer plan than trying to get then to believe you are just taking 50mcg, which really does run the risk of them reducing dose to 25mcg .( or even 0)
And it is much more respectful of your bodies complex balance which has only just started to feel better.
Once you've got a prescription for 100mcg or 112.5mcg and are settled on that and they are accustomed to the idea that your TSH is close to the bottom end , but you consistently feel better , and haven't dropped dead or gone running to A&E with heart palpitations ..... then even if they never agree to 125 , that is not so much of a problem to deal with by yourself by topping it up a little if need be .
But anyway you might actually find 100mcg or 112.5mcg is enough if you give it long enough to settle in.
I'll.delay the test can say work too.busy which it is now maybe for two months until end of June and lower dose and see what it comes out at then. If necessary will tell.her.
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